Although there are multiple effective typhoid vaccines available thoughout the world, drug-resistant typhoid fever is a growing concern in Pakistan and other parts of the world. The problem is that in some cases the bacteria that cause typhoid fever, Salmonella typhi, is becoming increasingly resistant to the antibiotics that are typically used to treat typhoid fever after people become infected with typhoid.
In Pakistan, a strain of Salmonella typhi known as H58 has emerged, which is resistant to multiple antibiotics including fluoroquinolones, which have been the mainstay of treatment for typhoid for many years. This has made it more difficult to treat the disease and has led to an increase in the number of cases and deaths. The spread of drug-resistant typhoid in Pakistan is thought to be related to a number of factors, including poor sanitation and limited access to clean water, which can lead to the spread of the bacteria. In addition, the overuse and misuse of antibiotics in both human medicine and agriculture can contribute to the development of drug-resistant bacteria.
To address this issue, Pakistan, the World Health Organization and other parties attempting to address the issue are using a combination of strategies including:
Increasing access to clean water and sanitation
Promoting the appropriate use of antibiotics
Implementing widespread vaccination programs
Conducting research to understand the epidemiology of drug-resistant typhoid and to develop new treatments and diagnostics
Improving surveillance systems to track and respond to outbreaks of drug-resistant typhoid
It's important to note that this problem is not limited to Pakistan, drug-resistant typhoid is emerging in many other parts of the world, and it's becoming a global public health concern.
Note that there are multiple very effective typhoid vaccines but they don't confer lifelong immunity. They only last for 2 to 5 years. It's also noteworthy that many developing countries lack the sanitation infrastructure to slow or stop the spread of typhoid, cholera and other diseases that can spread through drinking water contamination. In some instances this problem has actually gotten worse in the wake of the COVID-19 pandemic.
If you are planning to travel to Pakistan or another area with typhoid, including drug-resistant typhoid, we highly recommend you visit a travel clinic to get a typhoid shot (or pills) prior to your trip.